Tics or ????

J (4 yo) is starting to worry me with a few new behaviors, or not so new just more often and more intense.

She is not listening at all, just goes ahead and does what she wants even though I have told her not to. Such as: let the dogs outside unsupervised, feeding the dogs (read pouring dog food into their bowls till it's everywhere), disappearing on me and not answering when I call her. Which is SUPER scary as we live on 5 acres, with horses, dogs, hotwire fences, snakes, etc. Getting into everything. Running the water in the sink till it overflows. Putting on 15 outfits a day, at least, and putting all the ones she doesn't want to wear in the dirty clothes! UGH, that one makes me crazy.

All this I can and am trying to deal with, with do overs, time outs, etc. She is becoming a screeching banty rooster, I tell her not to do something and she starts making these horrid sounds, hard to describe. Pediatrician has thought she might be on the low end of the Autistic spectrum, so that might explain alot of these things.

The latest thing that is really concerning me is she is shrugging her shoulders, seemingly involuntarily, all the time. This has been going on for several weeks, or at least that is when I started noticing it. I have been trying not to make too much of it, don't want it to become an attention seeking behavior.

Does this sound like a tic? Are her screeching bouts concerning? She also tucks herself down in a ball while doing the odd sounds. Usually only lasts a few minutes but she is doing it more and more and not just at home either and not just for me.

I will be making an appointment with her pediatrician in the next week or so, as her Obsessive Compulsive Disorder (OCD)'s are getting worse as well. Lining up things, has fits if anything is moved. Gets totally into doing puzzles and I can't get her to stop if we need to leave or change activities. Temper tantrums will ensue along with the weird animal like sounds.

On the other hand, her word/letter/number/sounds recognition is off the charts. She told me the time on the clock today, first on the face clock then on the digital clock!!

She is sick right now with a head cold, or really bad allergies, not sure as we all are suffering with the winds being so bad right now.

Just bouncing stuff off you guys. Seems to me like her Autistic tendencies are becoming more pronounced, is that possible? I kinda thought you either had it or you didn't and it didn't get worse??

I think you have more than tics going on there. The stuff in the second paragraph sounds like a little person trying to be a grown up, pretty normal stuff. But the screeching while rolled in a ball is a very strange. The shrugging could be a tic. I doubt that mentioning it would turn it into attention seeking behavior because I simply don't believe that kids do things like that to get attention, for the long run. (I think that's a way over used concept considering most of our kids get plenty of attention.) But mentioning it won't enable her to control what she otherwise can't control, either.

I'm not one of the autism wonks around here but I would be concerned along those lines.

It's pretty common for kids with Autism Spectrum Disorders (ASD) to have traits that become more pronounced during this age that weren't so apparent during toddle/early preschool years. As I recall you had that possibility in mind for some time now so that wouldn't be unexpected. It's also common at various times in their lives--ie when making the transition between schools, when social demands increase to a degree they stand out, when they are in a new environment or uncontrolled situation, etc. I even have had college students show up on forums saying they struggled with Autism Spectrum Disorders (ASD) issues when younger but thought they were through it all and then they went off to college and things like sensory issues and stimming came flooding back.

The shoulder movement does sound like a tic. Tics tend to come and go, sometimes due to stressors, but sometimes for no apparent reason. My difficult child had some low key tics in preschool years but they've become more pronounced during elementary school. The screeching could also be tic behaviors. Here's a list of common tics at the Tourette's Plus website. You might want to take a look around as there tends is a lot of overlapping behaviors in kids with between Tourette's, Obsessive Compulsive Disorder (OCD), and Autism Spectrum Disorders (ASD)'s . From what you're describing I'd agree that Autism sounds likely but I'm all for borrowing from whatever camp I can when it comes to finding help for my kiddo!

Is she getting Occupational Therapist (OT) and are you using sensory calming strategies at home?

Is she reading yet and have you started doing social stories? Kids who are turned into written language can often absorb training and information better through that medium. I could see social stories as being potentially helpful for the safety issues. I probably be putting an alarm on the door if I were you so I was alerted when she escapes.

I just read about PANDAS, is there anyone here that knows anything about this? The sudden onset of shoulder shrugging, the increased Obsessive Compulsive Disorder (OCD) behavior, etc with her being sick now and she was sick about a month ago as well.

My nephew went through something similar (appeared to be sudden onset of tics) and they were thinking along the lines of PANDAS. In hindsight the parents realized there had been tic behavior all the time that greatly worsened around the time of the illness. Ending diagnosis wound up being Tourette's in his case so be sure and check both out.

My difficult child has tourettes and I'm just going to throw out some things. Shoulder shrugging was one of her tics. It came and went, as did most of her tics, all except the eye blinking, which was constant. She also had a stomach rolling type of tic that wasn't obvious to us, but when she told us about it, then I was able to notice it. Our DR then told us that while verbal tics were less likely in tourette patients, especially girls, when they are present, they are usually a repetitive grunt or squeal. My difficult child had echolalia - she would hear a phrase or tune and it would be stuck in her head for days, sometimes weeks and she would repeat it over and over again. I wanted to stab myself in the ears some days...but you learn to tune it out.

Her manifestations of Obsessive Compulsive Disorder (OCD) involved counting. She counted everything. She would run the micro and do jumping jacks and count them. If the micro beeped and she ended her jumping jacks on an odd number, she'd start over and adjust the speed of her jumping jacks so she ended on a positive number! She would count the stripes on her teachers shirt - to the point that we had to ask him to stop wearing striped shirts (and he complied!) and steps to and from the bus. Everything. Telephone posts, traffic lites, types of specific cars we passed, etc.

When she was sick with a cold or infection, her tics and Obsessive Compulsive Disorder (OCD) behaviors were always exacerbated or sometimes a new one would appear. Also, her tics and corresponding behaviors tend to wax and wane, which gives them a cyclic feel.

She's always had a difficult time switching from one task, such as jugsaw puzzles, to another, such as "okay, we're leaving now"...we learned early on that it was best to use a timer when we knew we would be leaving and giving her ample notice that a change was coming up. Spontaneous was just not something that went easy with her - still doesn't. So, we'd set the time about 10 minutes before we had to leave. It would go off after 5 minutes and she knew that then she had another 5 minutes and then we were changing tasks, etc. It helped - wasn't perfect but it helped.

When she was younger, routine and schedule really helped her to know and understand a certain order to her life. If it was a weekend and our time became to relaxed and free for all, difficult child would tend to get wired and by dinner time on a sunday, she'd be a mess. So, even on weekends, we had to have some type of order. *I'm thinking as I write this, it was a good thing for all of us - it made us spend a lot of quality family time together that we otherwise may not have had!

With the emergence of these new symptoms in your difficult child, it's definitely worth having your girl re-evaluated by a pediatrician neuro psychiatric. And maybe get a counselor to help you with creating and following certain routines that will work for your whole family and learning how to make transitions easier for her (and you!).